Health News

Physician Convicted in $10M Veteran Insurance Fraud Scheme

A federal jury found Alexander, Arkansas family physician Joe David May, MD, known locally as “Jay” May, guilty on all 22 counts for which he was indicted in a multi-million-dollar conspiracy to defraud TRICARE, the federal insurance program for US veterans.

The indictment alleged that May, 41, signed off on illegitimate prescriptions for pain cream. A pharmacy promoter paid recruiters to find TRICARE beneficiaries, then paid May and other medical professionals to rubber-stamp prescriptions for pain cream, whether or not the patients needed it.

As a result of this scheme, TRICARE paid more than $12 million for compounded drugs. May, according to evidence presented at the trial, wrote 226 prescriptions over the course of 10 months, costing TRICARE $4.63 million. All but one of these prescriptions were supplied by pharmaceutical sales representatives Glenn Hudson and Derek Clifton, according to federal officials. The sales reps passed the prescriptions to the providers, including May.

May accepted $15,000 in cash bribes and signed off on the prescriptions without consulting or examining patients to determine whether or not the prescriptions were needed. Hudson and Clifton have pleaded guilty in the scheme, according to the US Department of Justice.

The conspiracy was complex and involved recruiting patients. According to prosecutors, one recruiter, for example, hosted a meeting at the Fisher Armory in North Little Rock, where he signed up patients for the drugs and offered to pay them $1000. Thirteen of the patients from this meeting were sent to May, who signed the prescriptions. This group alone cost the veterans’ insurance program $370,000, say prosecutors. When the conspirators learned that reimbursements from TRICARE were set to decrease in May 2015, they rushed to profit from the scheme while there was still time. In April 2015 alone, May signed 59 prescriptions, contributing to the bilking of TRICARE for another $1.4 million.

According to a report in the Arkansas Democrat Gazette, May and Clifton, a former basketball coach, were longtime friends. Alexander Morgan, US Attorney and one of the prosecutors in the case, said that May signed the prescriptions at the behest of Clifton. According to the Gazette report, Morgan said the scheme was successful for as long as it was because “TRICARE is not in the business of catching fraud. Tricare is in the business of delivering health care to our nation’s veterans. They trust the professionals to do the right thing.”

May is currently licensed in Arkansas to practice family medicine, emergency medicine, and as a hospitalist. His license expires in September.

May is free pending a presentencing report. In addition to sentences imposed for fraud, mail fraud, falsifying records, and violation of antikickback laws, for which he faces up to 20 years in prison, May will serve an additional 4 years for convictions on two counts of aggravated identity theft.

Avery Hurt is a Birmingham, Alabama–based freelance science writer who writes often about the science and practice of medicine.

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